2025.07. 30 中国承担着全球43%的肝癌疾病负担。近年来，中国在肝癌防治领域已取得重大成效。在源头防控 方面，中国自2002年将乙肝疫苗纳入国家免疫规划后，全国新生儿接种率超过95%，使15岁以下儿 童乙肝感染率由原先的10%下降至1%以下。 本文字数：1051，阅读时长大约2分钟 作者 | 第一财经 钱童心 7月29日，全球顶级医学期刊《柳叶刀》（The Lancet）正式发布了一项由中国专家领衔的肝癌防 治重大报告，开创了该医学杂志200多年历史上"首次"由中国研究者牵头制订重大疾病应对策略的 先例。 这份《全球肝癌防治策略和行动计划》由复旦大学附属中山医院院长周俭教授、中国科学院院士樊嘉 教授等领衔，携手全球51位著名专家共同制订。 报告揭示了一项关键的发现——全球肝癌病因结构正发生显著变化。传统上，人们将肝癌与乙型、丙 型肝炎或长期酗酒直接联系，但如今，代谢障碍相关脂肪性肝病（MASLD）和代谢障碍相关脂肪性 肝炎（MASH）正在迅速崛起，成为肝癌发生的重要诱因，而肥胖和糖尿病加速了MASLD发展为 MASH的过程。 数据显示，全球MASH相关肝癌病例占比将从2022年的8%增至2050年的 ...

Core Insights - The report published in The Lancet marks a significant milestone as it is the first major disease response strategy led by Chinese researchers in the journal's 200-year history [1] - The report highlights a critical shift in the causes of liver cancer, with metabolic dysfunction-related fatty liver disease (MASLD) and metabolic dysfunction-related steatohepatitis (MASH) emerging as significant contributors, alongside traditional causes like hepatitis and alcohol consumption [1] Group 1: Key Findings - The proportion of liver cancer cases related to MASH is projected to increase from 8% in 2022 to 11% by 2050, a 35% rise, particularly in developed countries [1] - Alcohol-related liver cancer cases are expected to rise from 19% to 21%, while hepatitis B and C-related liver cancer cases are projected to decrease from 39% and 29% to 37% and 26%, respectively [1] Group 2: Prevention and Management - The report indicates that at least 60% of liver cancer cases are preventable by reducing risk factors such as viral hepatitis infections, alcohol consumption, and controlling metabolic dysfunction-related fatty liver disease [2] - China bears 43% of the global liver cancer burden, but has made significant progress in prevention, notably through the introduction of the hepatitis B vaccine into the national immunization program since 2002, leading to a drop in infection rates among children [2] - The application of new diagnostic and treatment technologies at Fudan University Zhongshan Hospital has improved the five-year survival rate of liver cancer patients to over 70% [2]

Core Viewpoint - The report published in The Lancet highlights the urgent need for comprehensive strategies to prevent and treat hepatocellular carcinoma (HCC), predicting a doubling of global cases by 2025 if no action is taken [2][6]. Group 1: Current Situation and Statistics - HCC is the sixth most common cancer globally and the third leading cause of cancer-related deaths, with 870,000 new cases and 760,000 deaths reported in 2022. Projections indicate that by 2050, new cases could rise to 1.52 million, and deaths could reach 1.37 million [8]. - The report indicates that over 70% of HCC patients are diagnosed at an advanced stage, resulting in a 5-year survival rate of only 5%-30% [13]. Group 2: Causes and Trends - By 2050, hepatitis B virus (HBV) will remain the primary cause of HCC, but its proportion is expected to decrease from 39.0% in 2022 to 36.9%. Conversely, alcohol-related HCC cases are projected to increase from 18.8% to 21.1%, and cases related to metabolic dysfunction-associated fatty liver disease (MASH) are expected to rise from 8% to 10.8% [10][11]. Group 3: Prevention and Early Detection - The report emphasizes that over 60% of HCC cases are preventable through the control of HBV, HCV, alcohol consumption, and fatty liver disease. For instance, in 2022, more than 540,000 of the 870,000 new cases were avoidable [15]. - Early screening can triple survival rates, as demonstrated in Japan, where 68% of HCC cases are detected at an early stage, leading to an 80% 5-year survival rate [17]. Group 4: Recommendations and Strategies - The committee has outlined ten actionable recommendations, including strengthening viral hepatitis prevention, reducing alcohol consumption, and improving early detection of HCC [19]. - Specific strategies include universal HBV vaccination, government-led measures to reduce alcohol consumption, and tailored national strategies to address the rising incidence of MASH [20]. Group 5: Stakeholder Involvement - The report stresses that reducing the global burden of HCC will require collaborative efforts from policymakers, healthcare providers, international organizations, researchers, and patient advocacy groups [21].

Core Viewpoint - The article emphasizes the urgent need for improved cancer prevention and treatment strategies in China, particularly focusing on liver cancer, which poses significant challenges due to late diagnosis, limited treatment options, and high recurrence rates [1][2]. Group 1: Challenges in Liver Cancer Treatment - Current challenges in liver cancer diagnosis and treatment include late diagnosis, limited treatment methods, and high postoperative recurrence rates [2] - Traditional screening methods have low sensitivity for detecting liver cancer smaller than 1 cm, leading to high rates of missed early diagnoses [2] - Approximately 90% of liver cancer patients in China are related to hepatitis B virus infection, highlighting the need for better vaccination and antiviral treatment [2] - There is a lack of public awareness regarding the "silent organ" nature of liver cancer, resulting in weak screening awareness among high-risk populations [2]. Group 2: Research Breakthroughs - The TIMES model, developed by Liu Lianxin's team, is a new immune scoring system that predicts postoperative recurrence risk based on tumor microenvironment heterogeneity [3] - This model utilizes five key indicators, including NK cell distribution, and incorporates artificial intelligence to guide immunotherapy decisions [3] - The research also identifies "immune desert" areas in the tumor microenvironment, where SPP1-positive macrophages inhibit immune cell activity, leading to the development of small molecule compounds and antibody drugs to enhance immunotherapy response [3]. Group 3: Technological Innovations - The use of AI imaging recognition systems and screening applications at Mengchao Hepatobiliary Hospital has improved early liver cancer detection rates [4] - A population screening project in Fujian Province has covered 2.3 million people, diagnosing 2,029 liver cancer cases and initiating interventions [4] - Advanced surgical techniques, including 3D reconstruction and fluorescence navigation, have significantly improved the precision and safety of laparoscopic liver resections, reducing postoperative complication rates [4] - AI-assisted systems are integrated throughout the entire "screen-diagnose-treat-recover" cycle, enhancing personalized follow-up and dynamic quality control, with patient compliance increasing by over 30% [4] - The advancements in liver cancer treatment position China among the global leaders, with significant achievements in surgical, interventional, and combined immunotherapy [4].